In 2011, the United States Military repealed its "don't ask, don't tell" policy that prevented gay and lesbian service members from disclosing their sexual orientation. Current estimates indicate that more than 1 million veterans identify as lesbian, gay or bisexual (LGB). Now, a University of Missouri researcher says these service members and veterans often are marginalized and may benefit from mental health professionals, including social workers, who are informed about the needs of individuals who identify as LGB.

"Identifying as LGB and serving in the military can provide a distinct set of experiences and challenges for individuals," said Michael Pelts, a doctoral student at the School of Social Work in the MU College of Human Environmental Sciences. "Within the U.S., identifying as a service member or veteran can marginalize individuals. This is also true for people who identify as LGB. The impact may be compounding. For example, suicide has a high occurrence rate among veterans and even more so among veterans who identify as LGB."

Pelts said studies show that the majority of LGB service members and veterans who seek mental health care services do so outside of Veterans Affairs.

"Social workers in the public and private sectors make up the largest group of mental health service providers to veterans and their families," Pelts said. "It is likely that social workers will continue to see current and new generations of veterans struggling with their sexual identity and with the impact of internal and societal stigmas related to identifying as LGB. Therefore, mental health professionals need to be equipped to care for members of this population."

Social workers and other mental health providers should challenge their cultural assumptions when treating clients who are veterans or service members, Pelts said.

"It's not ethically sound practice to assume that all service members and veterans are heterosexual," Pelts said. "Assuming individuals are heterosexual can compound stress for LGB individuals and make them less likely to share information, which can make it more difficult for health professionals and mental health providers to provide adequate care."

Pelts said health providers should adopt practices to be more inclusive to veterans who identify as LGB. Part of increasing inclusivity includes simple changes such as modifying medical history forms and in-take documents. By using more inclusive terminology, individuals who identify as LGB may feel less alienated, Pelts said.

"It is essential for mental health professionals to create culturally competent practice approaches," Pelts said. "Social workers have a tremendous opportunity, if not ethical responsibility, to be leaders in the provision of mental health services for LGB service members, veterans and their families."

Pelts recently wrote, "Veterans Mental Health: Implication for Services With Gay Men and Lesbians Who Have Served," which was published in Social Work in Mental Health.

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